Hip fractures are cracks or breaks in the top of the thigh bone (femur) close to the hip joint. They're usually caused by a fall oran injury to the side of the hip, but may occasionally be caused by a condition, such as cancer, weakening the hip bone.

Falls are very common in older people, who may have reduced vision or mobility and balanceproblems.

Hip fractures are alsomore common in women,who are more susceptible to osteoporosis (weak and fragile bones).

This topic covers:


When to seek medical help

Hospital assessment





Symptoms of a hip fracture

Symptoms of a hip fracture after a fallmayinclude:

  • pain
  • not being able to lift, move or rotate (turn) your leg
  • being unable to stand or put weight on your leg
  • bruising and swelling around the hip area
  • a shorter leg on the injured side
  • your leg turning outwards more on the injured side

A hip fracture won't necessarily cause bruising or prevent you from standing orwalking.

When to seek medical help

If you think you've fractured your hip, you'll need to go to hospital as soon as possible. Dial 999 for an ambulance.

Try not to move while you're waiting for the ambulance and make sure you keep warm.

If you've fallen, you may feel shaken or shocked, but try not to panic. Try to get someone's attention by:

  • calling out for help
  • banging on the wall or the floor
  • using your aid call button (if you have one)

The doctor carrying out the assessment may:

  • ask how you were injured and whether you had a fall
  • ask if this is the first time you've fallen (ifyou didfall)
  • ask about any other medical conditions you have
  • ask whether you'retaking any medication
  • assess how much pain you're in
  • assess your mental state (if you fell and hit your head, you may be confused)
  • take your temperature
  • make sure you're not dehydrated

Depending on the outcome of your assessment, you may be given:

  • painkilling medication
  • a local anaesthetic injection near yourhip
  • intravenous fluid (fluid through a needle into a vein in your arm)

The healthcare professionals treating you will make sure you're warm and comfortable. After a while, you may be moved from the emergency department to a ward, such as an orthopaedic ward.

To confirm whether your hip has been fractured, you may require imaging tests such as:

  • an X-ray
  • a magnetic resonance imaging (MRI) scan
  • a computerised tomography (CT) scan

Treating a hip fracture

Surgery is usually the only treatment option for hip fractures.

The National Institute for Health and Care Excellence (NICE) recommends that someone with a hip fracture should have surgery within 48 hours of admission to hospital.

However, surgery may sometimes be delayed if the person is unwell with another condition and treatment would significantly improve the outcome of the operation.

In about half of all cases, a partial or complete hip replacement is needed. Theother casesrequire surgery to fix the fracture with plates and screws or rods.

The type of surgery you need depends on a number of factors, including:

  • type of fracture (where on the femur it is)
  • your age
  • your level of mobility before the fracture
  • the condition of the bone and joint for example, whether or not you have arthritis

Read moreabout treating a hip fracture .

Recovering from hip surgery

The aim after surgery is to speed up recovery to help regainyour mobility.

The day after surgery, you should have a physiotherapy assessment and be given a rehabilitation programme that includes realistic goals for you to achieve during your recovery. The aim is to help you regain your mobility and independence so you can return home as soon as possible.

It may be possible to be discharged in three to five days.

Evidence suggeststhatprompt surgery and a tailored rehabilitation programme that starts as soon as possible after surgery can significantly improve a person's life, reduce the length of their hospital stay and help them recover their mobility faster.

The pads absorb the shock of a fall and the plastic shields divert the impact away from vulnerable areas of the hip.

In the past, one of the biggest issues with hip protectors was that many people found them uncomfortable and stopped wearing them. Modern hip protectors have tried to address this by having a more comfortable fit and additional features, such as ventilation to reduce sweating.

NICE suggests that hip protectors may be useful for older people in care homes who are considered to be at high risk of a fall. They're thought to be less effective for elderly people who remain active and live in their own home.

Read the fullNICE guideline on falls: assessment and prevention of falls in older people .

The FRAX tool

The World Health Organization (WHO) has developed a 10-year Fracture Risk Assessment Tool to help predict a person's risk of fracture in the age range 40-90 years.

The tool is based on bone mineral density (BMD) and other relevant risk factors such as age and sex.

Content supplied by the NHS Website

Medically Reviewed by a doctor on 12 Oct 2016